Infant and Maternal Outcomes in the Pregnancies of Asthmatic Women

Demissie, Kitaw; Breckenridge, Mary B.; Rhoads, George G.

doi:10.1097/00006254-199906000-00002

Cited by 31 publications

(66 citation statements)

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“…Previous studies have demonstrated that asthmatic pregnant women with asthma were at substantially increased risk for many adverse pregnancy outcomes. 22,23 Pharmacological therapy for asthma is often necessary during pregnancy. However, an increase in the risk of congenital malformation associated with the use of certain antiasthmatic drugs such as salbutamol during pregnancy has been observed, 24 suggesting the need to choose less toxic antiasthmatic drugs even if pharmacological therapy for asthmatic mother is indicated.…”

Section: Commentmentioning

confidence: 99%

Patterns of pregnancy exposure to prescription FDA C, D and X drugs in a Canadian population

et al. 2008

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Objective: To examine prescription Food and Drug Administration (FDA) C, D and X drugs in general obstetric population.Study Design: Historical cohort study.Result: A total of 18 575 women who gave a birth in Saskatchewan between January 1997 and December 2000 were included. Among them, 3604 (19.4%) received FDA C, D or X drugs at least once during pregnancy. The pregnancy exposure rates were 15.8, 5.2 and 3.9%, respectively, for category C, D and X drugs, and were 11.2, 7.3 and 8.2%, respectively, in the first, second and third trimesters. Salbutamol (albuterol), trimethoprim/sulfamethoxazole (co-trimoxazole), ibuprofen, naproxen and oral contraceptives were the most common C, D, X drugs used during pregnancy.Conclusion: About one in every five women uses FDA C, D and X drugs at least once during pregnancy, and the most common prescription drugs in pregnancy are antiasthmatic, antibiotics, nonsteroid anti-inflammation drugs, antianxiety or antidepressants and oral contraceptives.

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Section: Commentmentioning

confidence: 99%

Patterns of pregnancy exposure to prescription FDA C, D and X drugs in a Canadian population

et al. 2008

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“…2 It represents a risk of potentially serious maternal and fetal morbidities, including preterm delivery, gestational hypertension, preeclampsia, low birthweight, and neonatal mortality. 3,4 In addition, pregnancy may also influence asthma control with the deterioration of symptoms in one third of all pregnant women with asthma. 5 Notably, if the disease is well controlled, the risks of poor pregnancy outcomes decrease 6 ; therefore, maintaining optimal control in this period is crucial.…”

Section: Introductionmentioning

confidence: 99%

Relationship of Circulating C5a and Complement Factor H Levels With Disease Control in Pregnant Women With Asthma

et al. 2016

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BACKGROUND: Asthma often complicates pregnancy and represents a risk of serious pregnancy complications. The complement system contributes to asthma pathogenesis and is up-regulated in healthy gestation as well. The anaphylatoxin C5a has a major pro-inflammatory role, and the complement factor H is a main soluble regulator protein both in asthma and during pregnancy; however, peripheral levels of these complement factors and their relationship to disease control have not yet been evaluated in pregnant subjects with asthma. METHODS: The present study aimed to investigate circulating C5a and complement factor H levels in asthma (non-pregnant subjects with asthma; n ‫؍‬ 19) and in pregnancy with asthma (pregnant subjects with asthma; n ‫؍‬ 22), compared with healthy non-pregnant (n ‫؍‬ 21) and healthy pregnant women (n ‫؍‬ 13) and to test their relationship to clinical parameters of asthma (lung function, airway inflammation, and symptoms). RESULTS: Circulating C5a levels were higher in the pregnant asthma subject group compared with the healthy non-pregnant, healthy pregnant, and non-pregnant asthma groups: median 2.629 (interquartile range [IQR] 2.257-3.052) ng/mL versus 1.84 (IQR 1.576 -2.563), 1.783 (IQR 0.6064 -2.786), and 2.024 (IQR 1.232-2.615) ng/mL, respectively (P ‫؍‬ .02 in all cases). C5a correlated negatively with FEV 1 (r ‫؍‬ ؊0.44, P ‫؍‬ .039) and FVC values (r ‫؍‬ ؊0.64, P ‫؍‬ .001) in the pregnant asthma group and positively with fraction of exhaled nitric oxide levels in the nonpregnant asthma group (n ‫؍‬ 12, r ‫؍‬ 0.78, P ‫؍‬ .004). Complement factor H levels were elevated in both the healthy pregnant and pregnant asthma subject groups compared with the healthy non-pregnant group (median 1,082 [IQR 734.9 -1,224] and 910.7 [IQR 614.5-1076] g/mL vs 559.7 [IQR 388.7-783.1] g/mL, P ‫؍‬ .002 and P ‫؍‬ .004, respectively) but not in the pregnant asthma group compared with the non-pregnant asthma group (median 687.4 [IQR 441.6 -947.6] g/mL, P ‫؍‬ .10). CONCLUSIONS: Asthma during pregnancy increases the circulating level of pro-inflammatory C5a, which is accompanied by impaired lung function and partly counteracted by the gestation-specific elevation of regulatory complement factor H level (detected in pregnancy both in healthy and subjects with asthma).

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“…Increased risks of low birth weight (LBW), small for gestational age (SGA), and preterm delivery have been reported with asthma. [4][5][6][7][8] Larger studies, however, have identifi ed fewer signifi cant adverse obstetric outcomes. 1,9,10 A multicenter prospective observational cohort study performed by the Maternal-Fetal Medicine Units Network evaluated the relationship between asthma severity and maternal and fetal morbidity among pregnant women with asthma and matched controls.…”

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confidence: 99%

The Effect of Active and Passive Household Cigarette Smoke Exposure on Pregnant Women With Asthma

Newman

Momirova

Dombrowski

et al. 2010

Chest

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A sthma is a common medical complication of pregnancy, affecting 6% to 8% of women. 1,2 Both the prevalence and morbidity of asthma are increasing in the general population. 3 The literature has been inconsistent regarding the relationship between asthma and adverse pregnancy outcomes. Increased risks of low birth weight (LBW), small for gestational age (SGA), and preterm delivery have been reported with asthma. [4][5][6][7][8] Larger studies, however, have identifi ed fewer signifi cant adverse obstetric outcomes. 1,9,10 A multicenter prospective observational cohort study performed by the Maternal-Fetal Medicine Units Network evaluated the relationship between asthma severity and maternal and fetal morbidity among pregnant women with asthma and matched controls. 11 This study demonstrated a strong relationship between asthma severity and exacerbation during pregnancy, as well as associations with nonpulmonary pregnancy outcomes, including cesarean delivery, preeclampsia, gestational diabetes, and Background: The article was designed to estimate the effect of active and passive household cigarette smoke exposure on asthma severity and obstetric and neonatal outcomes in pregnant women with asthma. Methods: We used a secondary observational analysis of pregnant women with mild and moderatesevere asthma enrolled in a prospective observational cohort study of asthma in pregnancy and a randomized clinical trial (RCT) comparing inhaled beclomethasone and oral theophylline. A baseline questionnaire detailing smoking history and passive household smoke exposure was given to each patient. Smoking status was confi rmed in the RCT using cotinine levels. Data on asthma severity and obstetric and neonatal outcomes were collected and analyzed with respect to self-reported tobacco smoke exposure. Kruskal-Wallis and Pearson x 2 statistics were used to test for signifi cance. Results: A total of 2,210 women were enrolled: 1,812 in the observational study and 398 in the RCT. Four hundred and eight (18%) women reported current active smoking. Of the nonsmokers, 790 (36%) women reported passive household smoke exposure. Active smoking was associated with more total symptomatic days ( P , .001) and nights of sleep disturbance ( P , .001). Among the newborns of active smokers, there was a greater risk of small for gestational age , 10th percentile ( P , .001), and a lower mean birth weight ( P , .001). There were no differences in symptom exacerbation or outcome between nonsmokers with and without passive household cigarette smoke exposure. Conclusions: Among pregnant women with asthma, active but not passive smoking is associated with increased asthma symptoms and fetal growth abnormalities. CHEST 2010; 137(3):601-608Abbreviations: ETS 5 environmental tobacco smoke; LBW 5 low birth weight; MFMU 5 Maternal-Fetal Medicine Units Network; OR 5 odds ratio; PROM 5 premature rupture of membranes; RCT 5 randomized clinical trial; SGA 5 small for gestational age

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Infant and Maternal Outcomes in the Pregnancies of Asthmatic Women

Cited by 31 publications

References 0 publications

Patterns of pregnancy exposure to prescription FDA C, D and X drugs in a Canadian population

Patterns of pregnancy exposure to prescription FDA C, D and X drugs in a Canadian population

Relationship of Circulating C5a and Complement Factor H Levels With Disease Control in Pregnant Women With Asthma

The Effect of Active and Passive Household Cigarette Smoke Exposure on Pregnant Women With Asthma

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